Tuesday, 28 February 2017

Children are exposed to
"unacceptably high levels" of alcohol marketing through sports
sponsorship and public adverts, according to a report.

Alcohol
Focus Scotland (AFS) said there was "clear evidence" that exposure to
alcohol marketing led children to start drinking at a younger age.

It has called for the Scottish government to take action.

Alcohol Focus Group is a sockpuppet of the Scottish government which has gathered together a group of the country's most fanatical 'public health' teeth-grinders, including Gerard Hastings, to push the SNP to do something that the SNP would love to do. The Scottish health secretary said last year...

“This government has made it clear we believe the UK Government should
do more to protect our children from exposure to alcohol advertising in
all its forms which is why we established a wider review of alcohol
advertising.”

The charade works like this. The government finds (or creates) a
charity, lavishes it with taxpayers’ money and encourages it to lobby
for taxes and regulation. After a few years of astro-turf campaigning by
state-funded activists, the government passes laws which punish,
stigmatise and exploit its citizens while claiming to be capitulating to
the demands of civil society.

I was recently interviewed by the consumer website A Spokesman Said about sugar taxes and minimum pricing...

The government says it isn’t a tax on consumers. Instead,
costs will be absorbed by companies that make sugary drinks – what do
you say to that?

George Osborne presented it as a tax on corporations, but that was just spin. The evidence from other countries shows that companies nearly always
pass taxes onto consumers (as economic theory would predict).

Indeed, they tend to pass it onto consumers and then some. So, that
bottle of Coke is probably going to be rounded up from £1.92 to £1.99.

Osborne also tried to portray the tax as optional on the basis that
the ‘corporations’ wouldn’t have to pay it at all if they take all the
sugar out of their drinks.

That is obviously silly. As long as there is demand for sugary drinks, the companies are going to keep producing them.

I won't respond to all his points because some of them are not really arguments for drug legalisation at all - they are just arguments he has with legalisers from time to time. In particular, he spends a lot of time arguing against people who say 'what about alcohol, tobacco, motorcycles etc?' That line of attack can expose the double standards of some prohibitionists but it cuts no ice with Hitchens because he would happily ban these products too if it were feasible. I shall therefore pass over that argument and address some of his other points.

'WHY ALLOW CRIMINALS TO CONTROL THE TRADE? MAKING IT LEGAL WOULD DRIVE THEM OUT'

This is demonstrably untrue. Alcohol and tobacco( see above) are legal. Yet in Britain, HM Revenue and Customs use huge resources trying to combat the criminal gangs which smuggle illicit cigarettes into the country, or who manufacture and distribute illicit alcohol. This is because they are very heavily taxed, just as legal marijuana would be very heavily taxed. In fact it is already being taxed in Colorado, on the US states which has legalised it. Illegal sellers still operate there, trading at well under the taxed price in legal outlets.

Nobody claims that prohibition is the sole cause of black market activity. Britain has a thriving black market in alcohol and tobacco because it has taken the advice of people like Peter Hitchens and introduced every measure short of prohibition to deter the sale of these products. Taxation, in particular, has created demand for illicit goods because, as John Stuart Mill once wrote, 'every increase of cost is a prohibition, to those whose means do not come up to the augmented price.'

If Britain had a less punitive system of sin taxes, criminals would be driven out of these markets. Criminal manufacturers will never be able to produce products more cheaply than legal corporations. The only reason there is a price gap between the licit and illicit product is that paternalistic governments have set taxes too high.

By contrast, if we had full prohibition the market would be entirely run by criminals. The fact that there is a significant amount of criminal activity in a market that has several characteristics of an illicit activity, as tobacco does (artificially high prices, no advertising, and now no branding) is an argument for less regulation in that market, not prohibition in another.

As with tobacco and alcohol in Britain, the tax on cannabis is Colorado is so high that it is cheaper to buy it on the black market. It should be lowered.

All crime is caused by law

In any case, no thought has gone into this. All crime is caused by law. To have law means to have crime. If you have no law, you will have no crime. But think what this means in reality. If we banned nothing, we’d need no police, courts or prisons. But we’d also live in much worse, more dangerous and unpleasant world. We ban things because they are dangerous or have other evil effects.

It is trivially true to say that there would be fewer crimes if there were fewer laws, and it is true that this is not an argument for repealing laws. The real question is whether cannabis is sufficiently 'dangerous' to justify prohibition and whether the costs to the 'police, courts or prisons' are justified given that smoking cannabis is a relatively benign self-regarding behaviour. The costs of enforcing prohibition are real and they fall on the general taxpayer. Prohibition, in other words, creates negative externalities for everybody in society.

'Evil effects' are not sufficient to justify prohibition. People should be free to impose costs on themselves. Prohibition can only be justified if there are negative externalities which exceed the negative externalities of prohibition, and which cannot be captured with a Pigouvian tax. In general, however, smoking marijuana is a victimless crime that does not tick these boxes, although Hitchens disagrees...

'MARIJUANA USE IS A VICTIMLESS CRIME'

Only
if you do it on a desert island, quite alone, and nobody loves you. In
all other cases, the user runs the risk of doing himself serious harm (
see below on correlation between cannabis use and mental illness). And
if he does, his family will be terribly grieved and quite possibly
forced to look after him, and pay for his upkeep for the rest of this
natural life. They are victims. Alternatively, the user may end up in a
mental hospital, expensively cared for at the charge of the taxpayer,
who is also his victim. Even so his family’s grief and distress will
last for as long as they live.

This is a reference to the alleged link between cannabis and schizophrenia. Given the widespread use of cannabis and the relative scarcity of schizophrenia, we might assume that the risk to any individual cannabis smoker - if it exists at all - is not great. Hitchens nevertheless wants people who smoke cannabis to be thrown in prison pour encourager les autres on the basis that the hurt or cost to third parties is intolerable.

Since people can be 'terribly grieved' about all sorts of things, and since taxpayers foot the bill for most health and welfare costs, it is difficult to think of many activities that are truly victimless (and therefore permissible) under Hitchens' definition. It is a principle that, as Mill might say, 'acknowledges no right to any freedom whatever, except perhaps to that of
holding opinions in secret'.

In any case, it is not clear why Peter Hitchens cares more about an individual's loved ones than the individual does. If the friends and family of a cannabis user have a self-interested stake in his well-being, they can argue and reason with him. Ultimately, however, they must accept that his life is his own and that there is no duty on an individual to minimise every risk in case they wind up upsetting their friends or visiting an NHS doctor.

Nor should we assume that parents who have suffered as a result of their children taking drugs necessarily support Hitchens' position. The Anyone's Child campaign is run by dozens of parents who believe that their children would still be alive if drugs were re-legalised and regulated.

Why are cynical businessmen so much better than criminal gangs?

Why exactly are cynical businessmen better than criminal gangs?, who can wrap their dangerous products in pretty packets and sell them in shops and on the internet, and advertise them on TV and in cinemas, so much more desirable than criminals? Criminals cannot do these things, and can reach many fewer people than cynical businessmen.

On the other hand, Hitchens is right to say that 'cynical businessmen' try to make their products look attractive and tell people that they exist, subject to statutory limits on commercial speech, up to and including total prohibition. Manufacturing 'pretty packets' hardly seems comparable to mass murder, however.

In any case, this is what the UK's best selling cigarette looked like before plain packaging was introduced:

Does the fact that cigarettes and alcohol are sold openly and ‘regulated’ mean they are safe to use and will not harm you?

Why then would it mean that legalised drugs were safe to use and would not harm you? By ‘regulating’ them, society and the state would be offering a reassurance they were not entitled to give. They would be looking the other way while something inherently dangerous was put on open sale. I can see why a greed merchant might accept this argument. But most marijuana legalisers regard themselves as being opposed to corporate cynicism. Why are they outraged at the sale of sugary drinks and greasy burgers to innocent children, but happy to ally themselves with the mighty lobby of Big Dope?

It is highly doubtful whether people interpret the legality of tobacco, alcohol or even sugary drinks as a 'reassurance' that they are totally without risk. Very few things are wholly safe. The question is whether regulated products are safer than unregulated products. Tobacco and alcohol are undoubtedly safer than they would be if they were only available from criminals on the black market. Illicit alcohol was vastly more dangerous in America under Prohibition and it continues to be vastly more dangerous wherever it is consumed today. Illicitly produced cigarettes are also more dangerous than the real thing. If sugary drinks were only available on the black market it would not be long before we had our first spate of sugary drink-related poisonings.

Unless Hitchens believes that product regulation is totally useless and unnecessary, he must accept that unregulated products carry extra risks. This is undoubtedly true of drugs like heroin and Ecstasy which require the police to give users special warnings when unusually strong or adulterated batches hit the streets.

Meet The Real Mr Big - it’s You

These are the people who seek the dangerous, selfish pleasures of drugs. These are the real Mr Bigs of the drug trade. Without the cash they willingly hand over for their chemical joy, there would be no cartels, no smuggling, no mules, no gang wars.

This is why it is so astonishing that the people at the heart of the drug trade, the buyers and users, are the only ones in whom the law is utterly uninterested. If they were systematically arrested and prosecuted, the drug trade would rapidly dwindle, most of all in the places now enslaved by it.

No Mr Hitchens, The Real Mr Big is you and your fellow prohibitionists. Without drug prohibitionists, there would be 'no cartels, no smuggling, no mules, no gang wars.' There were none of these before the war on drugs started and there will be none of them when it is finally ended. It is fatuous to blame the victims of the drug war for the inevitable consequences of the prohibitionists' utopian fantasies.

'BUT YOU CAN’T PUT HUNDREDS OF THOUSANDS OF PEOPLE IN PRISON'

No, you can’t. The point of prison is to deter. Once it is clear that a crime is being taken seriously, its incidence falls ( see Japan and South Korea and pre-1971 Britain). A fairly small number of high-profile arrests and prosecutions, and the use by police of informers on a large scale so that nobody knew if they were in fact buying from a police nark, would rapidly persuade most people that drug abuse wasn’t worth the risk. And if everyone had heard of someone who *had* been jailed for drug possession, they’d change their behaviour. Drug abuse is a crime of affluence and choice. Anyone can stop committing it if he wants to. Nobody needs to do it.

Nice theory, but it hasn't worked in the United States where drug users are routinely sent to prison, nor in countries such as Russia or Iran which treat drug users even worse. The idea that people will stop taking drugs if word gets around that you can be sent to prison for it is naive. It is well known that large numbers of people are sent to prison for many years for the crime of dealing drugs, and yet drug-dealing continues.

Dictators love having stupefied subjects. They’re easier to fool, and to push around

Self-stupefaction is not some mighty freedom, like the freedoms of speech, thought and assembly. It is rather the opposite. Any tyrant would be glad to have a stupefied, compliant and credulous population, accepting what it was told and too passive and flaccid to resist. See Huxley’s ‘Brave New World’, inn which the masses are controlled by the pleasure-drug Soma.

This slightly conspiratorial theory is not borne out by experience. Nearly every government in the world has banned narcotics. Only a tiny handful have legalised cannabis. Even if we accept the idea that 'dictators love having stupefied subjects' it is a matter of historical record that the worst dictators have fought the war on drugs more savagely than anybody. Chairman Mao came close to wiping out opium use in China using the most brutal methods. Putin, like his communist predecessors, takes a zero tolerance approach. Rodrigo Duterte is currently massacring drug users in their thousands in the Philippines. And whilst it is true that Hitler dished out drugs to his soldiers, the Nazis' drug of choice - amphetamine - was hardly likely to stupefy them.

In short, if governments of any stripe want a stupefied population, they have a funny way of showing it.

Friday, 24 February 2017

I have written before about the sketchy guesswork used by the government to estimate the size of the illicit tobacco market. HMRC's current methodology is to...

... estimate how many smokers there are and multiply it by the estimate
of how many cigarettes they each smoke. They then subtract the number
of recorded sales - plus an estimate of how much is bought legally
abroad - from the total and the figure that emerges is the amount of
non-duty paid tobacco.

I have suggested that the decline in legal tobacco sales since 2009/10 - when tobacco taxes began to rise well above inflation - has been far greater than the decline in smoking prevalence would predict. In 2009/10, 49 billion cigarettes were sold. By 2014/15, this had fallen to 33 billion, meaning that sales had fallen by a third. Sales of hand-rolling tobacco, meanwhile, had remained the same at around 6.6 million kilograms. The graphs below show legal sales of cigarettes and other tobacco (mainly hand-rolling tobacco) since 1992. Note the big dip in 2000 when cross-border shopping from the EU began in earnest.

Over this period, the smoking rate has fallen by just 10 per cent (or two percentage points), from 21 per cent to 19 per cent, and half of that drop has taken place since 2010. Since 2010, the smoking rate has fallen by just five per cent but cigarette sales have fallen by more than a quarter. Moreover, the population has grown by four per cent.

It is possible that this can be explained by smokers sharply cutting down their consumption (perhaps because of e-cigarettes), but it is also possible that higher prices have pushed more people into the illicit market.

Or it could be a bit of both. Unfortunately, the HMRC estimates are so rough and ready that it is impossible to tell. Last time I wrote about this, HMRC figures showed a rise in the illicit market share since 2011/12 (from 7 per cent to 10 per cent in 2014/15), but no real change since 2009/10 when the estimate was 11 per cent.

It should be noted that any figure between 4 per cent and 12 per cent is possible in any of these years. Look at the confidence intervals. This is a broad guesstimate that depends on a lot of assumptions.

The importance of assumptions can be illustrated by looking at the most recent HMRC estimates which use an updated methodology. All the figures have suddenly changed. Whereas HMRC previously found no change between 2013/14 and 2014/15, they now find a four percentage point decline - from 11 per cent to 7 per cent - followed by a near-doubling of the rate, from 7 per cent to 13 per cent.

HMRC say that their new methodology takes into account evidence about people who 'falsely deny they smoke'. Rightly so, but estimating how many smokers claim to be non-smokers also involves a large element of conjecture. Does the new methodology get us any nearer the truth? It is hard to say. What is clear is that the figures are highly sensitive to changes in assumptions.

HMRC add their estimate of the illicit market to the legal sales data and conclude that the total number of cigarettes sold in Britain (legal and illegal combined) has fallen from 56 billion in 2009/10 to 38.5 billion. This is a drop of nearly a third (31 per cent) in a period when smoking prevalence has declined by just ten per cent and the population has grown by four per cent. And so the puzzle remains.

A reduction in the number of cigarettes smoked per person offers a partial explanation. The ONS says that average daily cigarette consumption in England fell by two percentage points between 2009 and 2012 (from 14 to 12 for men and from 13 to 11 for women). Its most recent dataset shows a figure of 11 per day (both sexes combined). This suggests an overall decline in cigarette-per-smoker consumption of 18.5 per cent since 2009.

This is a substantial drop but not enough to explain the overall decline in (legal) sales. There were 49 billion cigarettes sold legally in 2009/10. Reducing this by 10 per cent to account for the decline in smoking prevalence takes it down to 44.1 billion.

Reducing that 44.1 billion by 18.5 per cent to take into account lower consumption by smokers gives us 36 billion.

Increasing that 36 billion by four per cent to take into account population growth gives us 37.4 billion.

But HMRC records legal sales of 31 billion in 2015/16.* HMRC reckon that a further 1.5 billion cigarettes were brought in from the EU legally. This takes our 37.4 billion down to 35.9 billion, so we are still five billion cigarettes short of what we might expect, but this could be partially explained by a shift to rolling tobacco. Despite the decline in smoking prevalence, sales of hand-rolling tobacco remain the same as they were in 2009/10.

This is a rough and ready calculation, but it suggests that HMRC's estimate that the illicit trade makes up between 8 per cent and 17 per cent of the cigarette market can be justified, although the real figure seems closer to the high end than the low end. HMRC's mid-point estimate of 7 per cent for the previous year certainly looks implausibly low.

Even if HMRC's mid-point estimate of 13 per cent is correct, the number of illegal cigarettes on the UK market is mind-boggling. It suggests that six billion cigarettes were sold on the black market in 2015/16, along with ten million kilograms of rolling tobacco. That's in addition to 1.5 billion cigarettes and 3.2 million kilograms of rolling tobacco that avoid UK duty by being brought in legally from the EU.

And, to repeat, HMRC's estimates are incredibly sensitive to changes in assumptions. For example, if the average smoker consumes 11.5 cigarettes a day, as opposed to 11.0 cigarettes as assumed above, it leaves another 1.5 billion cigarettes unaccounted for.

We are talking about a serious problem for the government and yet there does not seem to be any serious effort being made to establish the facts. For a relatively small outlay, the government could conduct empty pack surveys and get a better idea of what is going on. Unfortunately, there are perverse incentives at work because some people would rather live in darkness than light a candle. The customs agencies want to be seen to have got a grip on tobacco smuggling and the government (along with anti-smoking groups) wants to believe that it can raise taxes without fueling the black market.

Secondly, that whichever methodology is used, the
illicit cigarette market has grown in recent years as a share of the overall
market. The 13 per cent mid-point estimate in the most recent dataset is
higher than it has been for a long time.

Thirdly, that there are reasons to think
that even 13 per cent could be a significant under-estimate, but until efforts are made to measure the illicit market properly, no one will know for sure.

Friday, 17 February 2017

This week I proposed replacing Britain's perverse system of alcohol duty with a flat tax on units of alcohol. A 9p/unit tax would pay for all the external costs of drinking to the government and would change the tax rates on a range of drinks as follows:

As you can see most - but not all - drinks would become cheaper. This is because drinkers are grossly over-taxed at present (ie. the tax revenue greatly exceeds the costs to public services). Cider, by contrast, is somewhat under-taxed.

A new briefing paper from the Institute of Economic Affairs shows
what a fair system would look like. British drinkers currently consume
approximately 50 billion units of alcohol a year. To recover the £4.6
billion in costs, there should be a flat rate of tax of 9p on every unit
of alcohol sold. That would mean a higher tax on some strong ciders and
a lower tax on other drinks. Overall, it would mean lower taxes, but
even after this reform most of our drinks would still be more expensive
than the European average. In the EU-27, the average duty on a pint of
lager is 14p (we currently pay 52p) and the average tax on a bottle of
wine is 44p (we currently pay £2.08).

Thursday, 16 February 2017

So the solution to the puzzle is that, objectively, poverty
hasn’t increased, but that people feel it has, which means that, in a
way, it has.

This could be read as the final, feeble pistol shot of the left after years spent predicting an epidemic of poverty due to 'austerity'/the Tories/the bankers that never appeared. In one line, Rentoul seems to have crystallised the left's preference for emotions over facts.

That is unfair, however. Badly worded though it is, Rentoul is making a point that is merely wrong, rather than insane.

It is a reference to the latest version of the Joseph Rowntree Foundation's Minimum Income Standard (MIS) which was published yesterday. JRF claims that 19 million people subsist on an inadequate income and are either in poverty or are 'at risk of poverty'. This is a rise of 4 million since 2008/09.

The MIS is based on what people in focus groups say they need to have an adequate standard of living. This is obviously subjective and, in practice, it is closer to an average standard of living than an 'adequate' one.

For example, here are some of the clothes that a mother of two needs to buy for herself (new) every single year in order to avoid being 'at risk of poverty', according to the MIS:

There are other items on the list that need to be bought more or less frequently, but that gives you a illustration. I'm not suggesting that this kind of annual wardrobe change is unusual for a woman, nor am I suggesting that you have to be rich to afford it. But to claim that you need to replace all this stuff every twelve months in order to have an 'adequate standard of living' is a bit of a stretch, in my view. And yet if you can't afford this, you are on the 'brink of poverty', according to the Independent.

I've written about the MIS before and was on the radio talking about it yesterday, so I won't go on about it here. Suffice to say, I don't think it measures poverty. The Joseph Rowntree Foundation also doesn't think it measures poverty and they are happy to confirm this when asked. But they can't stop the likes of The Guardian referring to the MIS as the 'poverty line' and I don't suppose they lose much sleep over people misrepresenting it as such.

Rentoul also interprets the MIS as a poverty line and he cites their figures as evidence that poverty has sort of got worse even though all the official evidence shows the opposite. For instance, here is the Office for National Statistics data showing income growth since 2007/08 (adjusted for inflation). Incomes have grown by 13 per cent in the bottom fifth. Only the richest fifth has seen a decline.

Since the strongest income growth has been in the poorest two fifths, it is hard to believe that four million people have been pushed into poverty an inadequate standard of living. JRF say this is because the cost of their basket of goods has risen by more than the RPI and CPI measures of inflation. I have no way of checking this but it would be surprising if the MIS basket was so dramatically different to the general basket of goods used by the government. It seems to be a partial explanation, at best.

Another explanation is that the JRF report stops at 2014/15 and thereby ignores the sharp rise in incomes seen in 2015/16. It is a shame they didn't wait a bit longer so they could get a more up to date picture (the new figures were published by the ONS last month).

In other words, there is very little supporting evidence for JRF's claims except - as Rentoul points out - people's intuition. Accepting all the ONS evidence, Rentoul asks the question:

So why do people feel that poverty and inequality have become worse?

In Rentoul's mind, the MIS holds the answer. People are getting wealthier but our definition of poverty keeps changing...

It would seem that the income most people think is needed for an
acceptable life has risen faster than incomes generally. So we would now
think of someone as “poor” if they cannot afford, say, a dishwasher,
when we wouldn’t have thought that was necessary in the 1980s.

This is true over the long-term, but I don't think the MIS has become conspicuously more generous since 2008/09. Even if it has, I don't think this explains the common belief that there is an epidemic of poverty and inequality.

I think there is a simpler explanation. Since at least 2008, the middle class left - as epitomised by The Guardian and Independent - has been asserting that poverty (a) is getting worse, and (b) will get even worse very soon. At first this was because of the recession - a plausible supposition but one that, broadly speaking, turned out to be false. Then it was because of cuts to public services under the umbrella of 'austerity'. Then it was because of welfare reform. And now it is because of Brexit.

They have been wrong every time for reasons I discussed in this post. There has been no audit of previous failed predictions and it has been remarkably difficult to get the basic facts in front of the public. The people Rentoul is addressing don't 'feel' that poverty has got worse in the sense that they, personally, have been plunged into poverty. They believe poverty has got worse because that has been the implicit or explicit message of the Independent foryears.

They are simply misinformed - and they are happy to be misinformed because it suits their view of how the world works. That is why they cling to any crumb of evidence from the Joseph Rowntree Foundation or the Institute for Fiscal Studies while ignoring the Office for National Statistics. They are just wrong. No other explanation is required. People are wrong about all sorts of things and the belief in
immiseration is just one of them.

Tuesday, 14 February 2017

Jacob Grier has written an excellent article for Slateabout the junk science used to justify smoking bans. In particular, he looks at the ludicrous heart attack miracles than supposedly take place whenever people are prevented from smoking in pubs.

When studies sampling larger populations finally appeared, the reported declines in heart attacks began to shrink. A study of the Piedmont region of Italy
found a much lower decline of 11 percent, though curiously only for
residents under 60 years of age. England, which implemented a smoking
ban nationwide, presented the first opportunity to study the matter on a
national scale. Researchers there credited the ban with a heart attack reduction of just over 2 percent nationwide.

Critics noted that the rate of heart attacks in England had
also been falling in the years prior to the ban and that the reason for
the decline was still not clear. Regardless, the data there made it
obvious that the miraculous reductions claimed in smaller studies were
unrealistically high. Even so, despite acknowledging the wide variation
in findings and the admitted methodological limitations of the studies, a 2009 meta-analysis conducted by the Institute of Medicine
concluded that the impact of smoking bans on short-term heart attack
rates was real and substantial: “Even a small amount of exposure to
secondhand smoke… can cause a heart attack,” one member of the IOM panel
informed the New York Times, urging that “smoking bans need to be put in place as quickly as possible.”

This report had, however, omitted one of the largest studies of secondhand smoke and heart attacks conducted to date. A 2008 study covering the entire country of New Zealand—a
population smaller than England’s, but bigger than the American towns
previously studied—found no significant effects on heart attacks or
unstable angina in the year following implementation of a smoking ban;
hospitalizations for the former had actually increased.

Contradictory research continued to come in. A clever study led by researchers at RAND Corp.
in 2010 tested the possibility that the large reductions identified in
small communities were due to chance. They assembled a massive data set
that allowed them to essentially replicate studies like those in Helena,
Pueblo, and Bowling Green, but on an unprecedented scale. Whereas those
studies had compared just one small community to another, the RAND
paper compared all possible pairings of communities affected by smoking
bans to all possible controls, for a total of more than 15,000 pairings.
They stratified results by age in case there were differential effects
on the young, working age adults, or the elderly. And in an improvement
on most other studies, they also controlled for existing trends in the
rate of heart attacks.

The study found no statistically significant decrease in
heart attacks among any age group. The data also suggested that
fluctuations in heart attack rates were common, indicating that
comparisons of small communities would frequently turn up dramatic
reductions due purely to chance; large increases in heart attacks
happened about as often. This explained the headline-grabbing dramatic
results in places like Helena or Monroe County that eluded replication
in larger jurisdictions. The conclusion of the study was blunt: “We find
no evidence that legislated U.S. smoking bans were associated with
short-term reductions in hospital admissions for acute myocardial
infarction or other diseases in the elderly, children or working age
adults.”

A 2012 study of six American states that had instituted smoking bans came to a similar conclusion. So did a 2014 study,
which is notable for being co-authored by some of the same researchers
who had previously published papers suggesting that the Colorado towns
of Pueblo and Greeley had experienced reduced rates of heart attacks
after implementing smoking bans. When Colorado enacted a statewide ban,
the authors had an opportunity to see if their earlier results could be
duplicated across the larger population of nearly 5 million people. No
effect appeared. As an additional test, they re-examined the data
excluding 11 jurisdictions that had already implemented comprehensive
smoking bans: The statewide ban still showed no effect.

In the paper’s admirably honest commentary, the authors
reflected on the reasons that earlier studies, including their own, had
overstated the impact of smoking bans. The first is that small sample
sizes allowed random variances in data to be mistaken for real effects.
The second is that most previous studies failed to account for existing
downward trends in the rate of heart attacks. And the third is
publication bias: Since no one believes that smoking bans increase
heart attacks, few would bother submitting or publishing studies that
show a positive correlation or null effect. Thus the published record is
likely unintentionally biased toward showing a larger effect than truly
exists.

Friday, 10 February 2017

The NHS is in the depths of its annual winter crisis, with waiting times and demand at record levels, as the Telegraphreports:

The number of people waiting more than two months to start cancer treatment after an urgent referral was 25,157 in 2016 - the highest on record and almost double the 13,191 in 2010.

Official figures for December reveal just 86.2 per cent of A&E patients were seen within four hours - the worst figure on record.

One of the few benefits of the annual NHS crisis is that it focuses people's minds on the reasons why demand for health care is rising. Most of the time, people are happy to blame the usual scapegoats of smokers, drinkers and fatties, but this is rhetoric designed to pursue political objections. Most of the people in the health service know that it is nonsense and that the real cause of rising demand is the rapidly ageing population. When the winter crisis hits, this has to be acknowledged, because you stand no chance of solving a problem until you know what it is.

But there's always one chump who cannot see beyond 'public health' mythology. I hereby nominate Dr Ian McColl as my Moron of the Month...

Lord McColl, a former shadow health secretary and former professor of surgery at Guy's Hospital hit out at the dietary habits of young people during a House of Lords debate about rising pressures on the NHS.

"It's not so much the old people getting older - because old people have always been getting older," he said.

"The difference in the last 30 years is the grotesque increase in young people getting fatter and fatter."

This is so mind-bogglingly stupid that it barely requires rebuttal, but here are some facts. The graph below shows usage of A & E by age group.

The oldest age groups, along with infants, are most likely to attend A & E - and their numbers are growing rapidly. As the Telegraph notes:

Health officials say the service is coping with "unprecedented"
pressures amid a rising ageing population, with an extra 1 million
people aged 65 and over since 2010.

Here are the reasons why people go to Accident and Emergency:

Unsurprisingly, they are mostly accidents and emergencies, not chronic obesity-related conditions. In any case, you would have to be extremely obese to suffer from an obesity-related condition as a teenager.

And even if people were turning up to A & E to have their obesity-related conditions treated, teenagers have a lower rate of obesity than any older age group. 11 per cent of 16-24 year olds are obese, compared with 34 per cent of 55-64 year olds or 29 per cent of 75-84 year olds.

Yes, it is true that 'old people have always been getting older' (actually, it isn't, but let's be charitable and assume he means since the NHS was created). It is also true that the NHS budget has always been rising. It takes wilful ignorance or flat-out imbecility not to see that these two facts are connected.

It should go without saying, but let's say it anyway: the winter crisis in Accident and Emergency is not being caused by a glut of fat teenagers needing urgent treatment for their (largely non-existent) obesity-related diseases.

PS. In not entirely unrelated news, I call for the abolition of the House of Lords in today's City AM.

Thursday, 9 February 2017

More anti-vaping propaganda came out of America yesterday via that laughable rag Tobacco Control. I wrote about it for Spectator Health.

Ever since e-cigarettes became mainstream consumer products circa
2012, there has been a steady flow of anti-vaping scare stories. In the
last 12 months, it has become a flood. The stories nearly always emerge
from the US, usually from California, and focus to three claims: that
e-cigarettes are as dangerous as smoking, that they don’t help people
quit and that non-smokers who use them are more likely to start using
tobacco cigarettes.

These claims have been debunked so many times that they can fairly be
described as ‘zombie arguments’. Impervious to reason, they stagger on.
Only yesterday, a high-quality study
funded by Cancer Research UK showed that e-cigarettes are vastly safer
than smoked tobacco — but this will not stop someone in the Bay Area
claiming the very opposite next week.

For every piece of evidence showing that youth smoking rates have
plummeted since e-cigarettes became popular, there is a blowhard in
Philadelphia who insists that vaping is a gateway not only to smoking
but to crack cocaine. For every report from the Royal College of Physicians showing that e-cigarettes help people quit smoking, there are a hundred activist-researchers in San Francisco claiming that vaping makes quitting more difficult.

Six days after publishing their news report, the BBC has added a quote from FOREST opposing the idea of banning smoking shelters and has extended the accompanying propaganda video to include the same quote.

It has also added a screenshot from Facebook in a half-hearted attempt to show that views differ on this controversial issue.

Since nearly everyone who will ever read this story had already done so by the time it had some balance injected into it, this isn't much of a victory, but hopefully it will remind BBC journalists to make an effort to at least pretend to be impartial in the future. We can only dream.

Tuesday, 7 February 2017

Public Health England's alcohol report was based on a false narrative created by activists in the neo-temperance lobby. Its fundamental deceit was to claim that alcohol consumption and alcohol-related deaths were rising until the duty escalator was introduced in 2008, after which they fell.

The culprits were Nick Sheron and Ian Gilmore of the Alcohol Health Alliance who have repeated this claim again and again and who also claimed that alcohol-related deaths would rise after the beer and wine escalator was scrapped in 2013 and the spirits escalator was scrapped in 2014. The whole point of this charade is to portray price, consumption and mortality as inextricably linked and, therefore, to present endless price rises as the solution.

Sheron and Gilmore used some basic statistical tricks which PHE should have seen through. As I have previously discussed, if you measure alcohol consumption properly (ie. per capita), it peaked in 2004, not 2008. This seems a minor point but it is important since the peak in alcohol-related deaths and the introduction of the duty escalator occurred four years later. The correlation claimed by Sheron and Gilmore does not exist.

Although the decline in alcohol-related mortality does not exactly correlate with the decline in alcohol consumption (and is nowhere near as sharp as the 18 per cent decline in alcohol consumption), this graph could be used as prima facie evidence that the decline in alcohol affordability which came about as a result of the recession and duty escalator had an impact on mortality.

Perhaps it did, but if you dig a little deeper, that hypothesis looks shaky. Looking at the mortality rates in the UK's four countries reveals that the decline has largely been a Scottish phenomenon and it clearly began before 2008.

Alcohol-related mortality rate (males)

Alcohol-related mortality rate (females)

In Scotland, the alcohol-related death fell by more than a third between 2003 and 2012, from 47.7 per 100k to 29.9 per 100k for men, and from 19.6 per 100k to 12.5 per 100k for women.

But in England, there has been little change since 2003 despite a sharp decline in alcohol consumption and the introduction of policies that were supposed to make things better or worse, such as so-called '24 hour drinking' and the alcohol duty escalator. There was a clear rise between the early 1990s and early 2000s, but the trend has been largely flat ever since (rather like childhood obesity, as it happens).

If campaigners are going to attribute these changes to the affordability of alcohol, they need to explain why the trends have been radically different in Scotland than in England, despite both countries having the same tax rates.

While they're at it, they should explain why alcohol-related mortality is higher now than it was in 2001 despite alcohol consumption falling by nearly a fifth. Advocates of the total consumption model can no longer use the 'lag effect' as an excuse. The lag is not that long.

And they could tell us why there has been no rise in alcohol-related mortality since 2012 despite the alcohol duty escalator being ditched and rising incomes making alcohol more affordable.

Alcohol related deaths are most likely set to increase in England as incomes outstrip rises in taxation, argue experts in The BMJ today.

Meanwhile, the number of alcohol related deaths will likely continue
to decrease in Scotland if legislation on minimum unit pricing for
alcoholic drinks is implemented.

Time will tell, but there should be some acknowledgement that the total consumption model and the price-harm hypothesis have been poor predictors of outcomes so far, and that the decline in alcohol-related deaths has been most apparent in Scotland where it began several years before alcohol became less 'affordable'.

As an interesting side note, it seems likely that the statisticians are gearing up to create another epidemic overnight:

Upcoming changes to this bulletin

In the coming months we will be working to review our definition of alcohol-related deaths. This work is being conducted to improve the consistency of outputs on deaths related to the abuse of alcohol produced by different government departments across the UK. We will be holding a consultation on this definition in the summer of 2017 with the view to using an improved definition in our next release.

This is an opportunity for the anti-drinking cabal of quakademics such as Mark Bellis, Mark Petticrew and Ian Gilmore to get the ONS to abandon its proper definition of 'alcohol-related' (meaning 'caused by alcohol') in favour of a dubious system of partially-attributable fractions based on junk epidemiology.

There has been growing interest in the use of partially-attributable conditions to provide a truer burden of alcohol consumption on population health and use of health services associated with these conditions.

I bet there has. These people have already hi-jacked the Chief Medical Officer's office and Public Health England. They will be delighted to add the ONS's scalp to their collection.

Sunday, 5 February 2017

I was on The Big Questions (BBC1) this morning talking about poverty. Specifically I was trying to help answer the question 'Will more children be raised in poverty?' The topic may have been inspired by a report from the Resolution Foundation released this week which predicted falling living standards and rising inequality for the rest of the decade.

The Resolution Foundation report echoed the pessimism of a 2016 report from the Institute of Fiscal Studies which predicted no income growth for people in lower income brackets and a rise in absolute child poverty by 2020 ('absolute poverty' is defined as having an income that is 60% or less of the 2010/11 average, after adjusting for inflation). Both reports claimed that these negative outcomes could be avoided if the government abandons its plans to cut some out-of-work benefits. The IFS has since made headlines by claiming that it will take until 2021 for wages to return to 2008 levels thanks to Brexit.

I am sceptical about these gloomy forecasts. The Resolution Foundation and the IFS have been saying the same thing for so long that one day they are bound to be right, but that is the problem. They said the same thing when the government cut benefits at the start of the era of supposed 'austerity'. Since 2011, if not earlier, they have been predicting a wave of inequality, poverty and falling incomes. It's 2017 and it still hasn't happened.

If somebody kept offering me useless horse-racing tips, I would stop listening to them. Given their conspicuous failure to read the tea leaves of 'austerity' correctly, it is surprising that the media continue to take the IFS's prognostications so seriously. I suppose there is always a market for doom and gloom, especially when you are 'respected' and 'independent' - as the media insist the IFS is.

Actually it was worse than that. IFS modelled the data based on six different scenarios - high employment/low employment, benefit cuts/no benefit cuts, progressive/regressive earnings growth - but all but one of them predicted that the rate would be at least 23% by 2015/16. The sole exception was the 'no tax and benefit reforms' scenario but even that predicted a rise to 18.5%. In other words, they had six chances to get it right and overshot every time.

The IFS also made predictions about what would happen to incomes between 2007/08 and 2015/16. As shown in their graph (below) the outlook was grim, with every income group worse off by 2015/16 under almost every scenario. The sole exception was a small number of people at the bottom end whose incomes would rise slightly if the government abandoned its welfare reforms (are you starting to see a pattern here?).

In 2011, the IFS argued that people in the middle and high income brackets had already seen their incomes fall whereas the worst was yet to come for lower earnings. For 'those towards the bottom,' they said, who were 'dependent more on benefit incomes, falls in income will happen largely between 2010–11 and 2015–16'.

The Resolution Foundation struck a similar note in a 2011 report which predicted that incomes would remain below pre-crash levels for the rest of the decade and that incomes would fall to twentieth century levels for many poorer groups (see below).

This was followed in 2012 with the Resolution Foundation's Gaining From Growth report which predicted lower incomes for everybody except the rich. 'Even on optimistic growth assumptions,' they said, 'low income households in 2020 now look likely to have incomes 15 per cent below those in 2008'. They predicted that middle income households would have incomes three per cent below 2008 levels while richer groups would see a rise.

It is too early to categorically debunk the Resolution Foundation's forecast for 2020, but Office for National Statistics data allow us to put the IFS's predictions to bed. As the graph below shows, there was income growth across the distribution between 2007/08 and 2015/16 with the exception of the richest fifth who saw a 3% decline. The poorest fifth saw the biggest rise: 13 per cent above pre-crash levels by 2015/16.

As the ONS notes, median incomes are already £1,000 higher than they were before the crash :

'After taking account of inflation and changes in household structures
over time, the median disposable income has increased by £600 (or 2.2%)
since 2014/15 and is £1,000 higher than the pre-economic downturn level
observed in 2007/08.'

It seems to me that Office for National Statistics data should be more prominent in public debate than speculation from think tanks, but that is not how it works. I suspect that many people would be surprised by the evidence shown in the ONS graph above. Similarly, many people would be surprised to hear that rates of poverty and inequality have fallen in recent years. These are verifiable facts and yet it was the Resolution Foundation's hunch that inequality might finally rise that made the front pages this week.

In all fairness, economic forecasting is not easy. For a start, you have to rely on forecasts from other organisations about such variables as GDP, unemployment and inflation - and these are often wrong too. But the IFS/Resolution forecasts have not just been wrong, they have been woefully and utterly wrong.
We were told inequality would rise. It fell. We were told poverty rates
would rise. They fell. We were told incomes would fall. They rose. We were told the rich would do better than the poor. They did worse.

This
is a less effective system than flipping a
coin. It suggests something more than bad luck. It suggests a systemic bias towards doom and gloom.

A forecast is only as good as the assumptions it is based on and one of the flawed assumptions of the IFS and Resolution Foundation reports is the belief that benefit cuts will necessarily result in lower incomes for those who are on welfare. But this does not account for people changing their behaviour as a result of incentives. One of the reasons income growth has been particularly strong among the poorest fifth of households is, as the ONS has explained, that people have come off benefits and gone into work - and work pays more than benefits.

Now the Resolution Foundation and IFS are back again, without a word of contrition, to double down on their forecasts for 2020. This time, they tell us that living standards/poverty/inequality are going to get worse because Brexit-inspired inflation will wipe out the effect of wage increases. Anything is possible, of course, but it is equally possible that employers will take inflation into account when offering pay rises. Businesses do this when inflation is in double digits so it does not seem unthinkable that they will to do it if inflation rises to the dizzy heights of two or three per cent (it is currently 1.6 per cent).

I am aware that I am leaving a hostage to fortune by writing this post. The economy could go belly up at any minute due to some unforeseeable shock and I'll be left with egg on my face, but we are talking here about probabilities. I believe it is probable that real incomes will be higher in 2020 than they are today and that absolute poverty will be lower. I make no prediction about the nonsense of relative poverty and I don't care about inequality, but if the economy continues to grow, it would be surprising if the IFS and Resolution Foundation are correct in their predictions.

Real incomes track GDP very closely (see section 4) and the historical record shows that growth is more likely than recession in any given year. The rate of inflation or the state of the welfare system have a trivial effect on real incomes in comparison to GDP growth. A rising tide lifts all boats. If you had picked any year at random from the last two centuries and were forced to bet on whether incomes would rise or fall in the next decade, you would be a fool to bet on a fall.

Friday, 3 February 2017

The Alcohol Health Alliance are calling for higher taxes on strong cider again. Thanks to the peculiarities of Britain's alcohol duty system, it is true that cider is somewhat under-taxed.While beer is taxed at around 18p per unit and spirits are taxed at 28p per unit, cider is taxed at 8p per unit, unless it is 'strong' in which case it is taxed at 7p per unit, unless it is sparkling in which case it is taxed at 34p per unit.

This is not very logical, to say the least, but British cider makers have a lot of influence in the marginal constituencies of the south-west. In 2011, the government responded to concerns about street drinking by taxing strong beer and cider - defined as anything over 7.5% - at a higher rate. Predictably, this led to a glut of ciders being produced at exactly 7.5%.

This would require a unit tax of 9p, but that is not what the AHA are demanding because they are not concerned about having an equitable tax system, they just want to stop people drinking. They naively believe that if you put up the price of the drinks favoured by alcoholics and street drinkers, you will tackle alcoholism and street drinking.

But, unless you tax alcohol by the unit, there will always be one drink that is cheaper than another and that is the drink that people with alcohol problems will gravitate to. It used to be meths and hard liquor, then it was strong beer. These days it is strong cider. If taxing strong cider makes some other drink become the cheapest choice, that is what people will turn to.

You don't address the causes of alcohol problems by making certain drinks more expensive. All that happens is that people with alcohol problems have less money for other things. As the apocryphal Russian father said to his son when the boy asked him if Gorbachev's tax on vodka means that he would stop drinking: 'No, it means that you will stop eating.'

This being the Alcohol Health Alliance, the demands for higher taxes rest their head on a pillow of lies. There are too many falsehoods and half-truths in their press release to fisk in detail but two whoppers stand out:

... one in five of all hospital admissions are alcohol related, while 70-80% of people attending A&E at peak times have been drinking.

In the same year, there were 18.7 million hospital admissions, so alcohol-related admissions made up 1.8 per cent of the total or, if you insist on using the broad measure, 5.9 per cent. Neither figure is anywhere near 'one in five'.

As for '70-80% of people attending A & E at peak times have been drinking', this seems to be aimed at perpetuating the tabloid myth that Friday and Saturday nights are peak times for A & E. In fact, they see fewer attendances than average, as I explained in Alcohol and the Public Purse...

Friday and Saturday nights are not the busiest
time for A & E departments. For example, in 2012/13 there was an average
of 182,612 A & E attendances between 11am and noon on Tuesdays,
compared to 73,738 attendances between 11pm and midnight on Saturdays.

Even if weekend evenings were 'peak time', there is no evidence that 70-80% of attendances are alcohol-related. 'Public health' charlatans sometimes point to a study of A & E services in Newcastle to claim that over 70% of weekend attendances are alcohol-related but this is piffle. The study actually showed that fewer than 20% of weekend attendees had been drinking, with 12-15% being the overall weekly average. The number of attendees who had been drinking only exceeded 50% for a few hours between midnight and 4am at the weekend, but this is not 'peak time' and most sober are asleep at this time. Furthermore, the mere fact that the attendees had been drinking does not automatically mean that they were there for an 'alcohol-related' reason.

A number of public health professionals have advocated for various forms of taxes on fat, sugar, or other ―unhealthy ingredients (e.g., 18, 19), and a variety of locales have implemented such taxes. Presuming a downward sloping demand curve, an increase in the price of sugar or fat will likely lower consumption of these items, but the key question is: by how much? It is inappropriate to focus only on the own-price elasticity of demand. There are substitutes for, say, taxed sodas, such as milk, juice, or beer. The availability of caloric substitutes will lower the weight impacts of a tax beyond that implied by the own-price elasticity (20). That is one reason why some analyses show that only across-the-board food taxes will significantly affect weight (21).

A problem with food taxes is that they are regressive because the poor spend a higher proportion of their income on food than the rich. Because of concerns over regressivity of food taxes, others have proposed subsidies on health foods like fruits and vegetables. While such subsidies can improve uptake of such foods (22), questions about cost-effectiveness remain as do concerns about equity. Muller et al. (23) show that both unhealthy food taxes and healthy food subsidies favor higher income consumers. They find that unhealthy food taxes increase prices paid more for low than higher income women and that healthy food subsidies reduce the prices paid more for higher than lower income women.

On why computer models fail to predict the impact of sin taxes on obesity correctly...

... An issue often overlooked in economic analyses of ―fat taxes relates to metabolism. Metabolically, one must translate changes in consumption caused by a tax to changes in weight to fully appreciate the impacts of taxes or subsidies. The most common approach taken in the economic literature is to apply some version of the simply linear rule that ―3500kcal = 1 lb. However, as shown by Thomas et al. (26), the rule overstates actual weight losses resulting from a reduction in caloric consumption. These and other reasons help explain the seeming paradox that simulation models show sugared soda taxes to have pronounced effects on obesity prevalence, when actual variation in soda taxes across locations seems to have had no impact on body weight in the ―real world (27-30).

On why taxes on food and drink reduce consumer welfare...

... More fundamentally, it is useful to return to the conceptual basis being used to assert that sugar or fat taxes increase consumers‘ welfare. Taxing food or soda is analogous to reducing consumers‘ real income, which harms the consumer under the standard economic modeling framework (i.e., consumers do not like to pay higher prices). Even if taxes induce a change in body weight, presumably many consumers already consider health impacts when they choose what to eat and drink. If consumers suffer from an aforementioned behavioral bias or lack of information, it is possible to construct a model in which a soda or fat tax benefits the consumer. For example Lusk and Schroeter (34) showed that if consumers ignore future health impacts at the time of purchase, a tax can increase consumers‘ long-term welfare but only in the limited case when prices are very high and where the only consumption taking place is because ultimate health impacts are ignored.

It is true that taxes are required if we are to have public roads, public schools, and national defense. However, the typical economic approach is to identify taxes that create the least deadweight loss, with additional considerations given to tax progressivity. Even if revenue from ―fat taxes could be directed toward health education programs, it is far from clear that these sorts of taxes are the most efficient way to fund such education. Moreover, one would need to show how the deadweight loss of the tax is offset by the benefits of extra information; however, evidence on the monetary benefits of such proposed education programs is typically assumed rather than carefully estimated.

He concludes as follows:

This article presented a somewhat pessimistic view on the ability of government policy to substantively influence obesity prevalence. Obesity is a complicated and multifaceted issue. So too are the effects of anti-obesity policies. One response is to argue for an all-out ―war on obesity. It probably true that government policy mandating what farms grow, restricting the supply and type of food to consumers, and controlling prices, offerings, and advertisements by food manufacturers could reduce obesity prevalence. But, is this the type of coercive society in which we‘d like to live? Society faces very real tradeoffs between economic freedom, technological progress, and obesity prevalence. These sorts of tradeoffs are the unfortunate, but they reflect very real constraints to effective economic policy making.

The same issue of the journal carries an article by Martin Binks and Shao-Hua Chin which is also well worth reading. In particular, I was pleased to see that they have noticed the tendency of sugar tax campaigners to focus on changes in consumption when their predictions about obesity fail to materialise:

...clarity is needed in defining a priori what is or is not a reasonable and or desirable impact of obesity policy interventions. A most recent example can be found in the various regional efforts to reduce sugar sweetened beverage (SSB) consumption as a way of impacting obesity in France, Brazil, Mexico and more recently in Berkley California. In each case the stated primary goal was to impact obesity.

However, as the results were presented in the literature and summarized in a recent meta-analysis it is evident that there was no significant impact on BMI in terms of the actual population-based studies. Furthermore, simulations based on available data identify only a minimal potential impact (fractions of BMI points).

As a result of this failure to impact BMI, the dialogue has shifted towards highlighting reductions in consumption as an indicator of success. While the broader implications of this assumption are beyond the scope of this paper, it is important to note that

1) the goal was to impact obesity, this did not happen even over reasonable time periods
2) By focusing towards a secondary endpoint as a success, we may miss a real opportunity to uncover why consumption dropped yet BMI remained unchanged.

In short, it is necessary to consider why this primary endpoint was not met, and develop new approaches that will impact obesity, as opposed to defending those that have proven ineffective. The challenge faced is one involving the willingness to objectively evaluate the science (even when it opposes strongly held ideological beliefs), and to pursue comprehensive evidence-based solutions to obesity and the policies that may support them.

About Me

Writer and researcher at the Institute of Economic Affairs. Blogging in a personal capacity.
Author of Selfishness, Greed and Capitalism (2015), The Art of Suppression (2011), The Spirit Level Delusion (2010) and Velvet Glove, Iron Fist (2009).

"Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."